July 2017

TOOL TIME:
ZiaPartners has released CODECAT-EZ 2.0, a self assessment of co-occurring/complexity competency for individual service providers and their supervisors. This tool is used to plan competency development activities – as well as to measure progress – on an individual, team, program, agency, or system level. The updated language moves more to addressing “whole person care” and “complex needs,” as well as co-occurring Mental Health and Substance Use Disorders, to address how more and more programs are looking at multiple health, behavioral health and human service needs.
ZiaPartners has also released the ILSA (Integrated Logitudinal Strength Based Assessment) Supervision Workbook – a guide for supervisors helping staff to develop welcoming, recovery-oriented, co-occurring competencies, using the integrated, longitudinal, strength-based assessment framework for understanding clients and addressing their hopes and needs.Please contact info@ziapartners.com for information on how to obtain these new tools.

Activities in JulyMichigan Department of Community Health Co-occurring College: Ken was invited to provide a keynote address on “Changing the World: Welcoming, Integrated Services and Systems for People with Co-occurring Conditions” as well as two workshops (one on psychopharmacology guidelines for individuals with co-occurring disorders; one on developing a continuum of housing services for individuals with co-occurring disorders) at the annual Michigan co-occurring college in Traverse City on July 10. This event attracts hundreds of participants from all over the state to advance their learning of how to implement universal co-occurring capable services.
The Department of Community Health co-occurring co-ordinator, Mark Lowis, who plans and oversees this event, worked with ZiaPartners from 2004-2007 when he was the co-occurring coordinator for Oakland County Community Mental Health Authority in Auburn Hills.

At that time, ZiaPartners was working statewide to implement the Comprehensive, Continuous, Integrated System of Care in all of the regional community systems in Michigan. It was exciting to learn that Michigan has continued to build on and sustain this initial work, and all programs are monitoring their progress and engaging in continuing learning and improvement.
The level of experience, understanding, and sophistication that has been achieved in Michigan over the past decade is worthy of note, and should be recognized. We at ZiaPartners applaud their progress and are eager to help them continue the journey.
Oakland County Community Health Network (formerly Oakland County Community Mental Health Authority). As part of the statewide effort, Oakland county has continued to make progress in using the Comprehensive Continuous Integrated System of Care to build universal co-occurring disorder capability in its entire provider network. In this context, Ken was invited to provide two days of training (July 13-14) to groups of Substance Use Disorder providers to address issues that had been identified in their county Technical Assistance monitoring visits as needing attention, based on evaluation with the Duel Diagnosis Capability in Addiction Treatment co-occurring capability measurement tool for programs. This process revealed the level of sophistication and progress that Oakland County has made over the past decade in continuing to improve co-occurring services in all programs and staff. The training focused on integrated treatment planning, skill building, transition planning, and medication assisted treatment, and was extremely well received. ZiaPartners looks forward to continuing to support the Oakland Community Health Network and other community systems throughout the state.

Shout out to Sherrie Williams from the Community Health Network for putting the training together, and to Lenny Rosen, MD, Community Health Network Medical Director, who has been championing this process for over a decade, and who participated in day one of the training.

Meadows Mental Health Policy Institute: Houston Endowment Substance Use Disorder System Assessment of Houston/Harris County: Ken is the addiction psychiatry representative on the Meadows Mental Health Policy Institute team that is assessing the entire system of care for Substance Use Disorder services in Harris County, and during this month, data gathering interviews were fully in process. Ken spent two days in Houston (July 25-26) meeting with Sunstance Use Disorder providers, primary health providers, and criminal justice system representatives, as well as scheduling phone calls with Harris Health, the Health and Care Professional Council, the Houston County Public Health Department, Veteran Affairs representatives, Baylor University, University of Texas: Houston, and many others. This project is providing a wonderful opportunity to describe a public health/population health approach to substance use issues of all kinds in a large urban system, and to illustrate how Substance Use Disorders might be addressed in health, mental health, criminal justice, child welfare, and school environments, as well as in distinct Substance Use Disorder services, to illustrate the current evolution of best practice to addressing Substance Use Disorder at all levels of severity, including medication assisted treatment options, and to provide a road map to guide Houston Endowment, other funders, and other system partners for how to make investments to guide next steps of progress.McAlister Institute: Ken and Chris began their second year of work with McAlister Institute in San Diego County, on July 20-21. This project is working on continuous improvement of welcoming, recovery oriented integrated care in all programs among all staff, covering both youth and adults, and different levels of care (detox, outpatient, residential, etc.). All programs are continuing to work on finding improvement opportunities to improve welcoming, access, and individualized integrated service delivery for individuals with complex needs. The agency has developed a “scope of practice” for any person providing help to define the appropriate sets of interventions and competencies to provide integrated services to individulas with co-occurring conditions.

In addition, the agency provided specific guidelines within its manuals for how to work as an “integrated team”. The specific training content of this visit included a live interview with a volunteer who had co-occurring conditions, to illustrate how to do the Integrated Longitudinal Strength Based Assessment. The other training focus was an introduction to how to use the American Society of Addiction Medicine criteria to individualize level of care determination for people with complex needs, using case examples. There is a strong level of positive energy and excitement for the clinical and organizational changes that are occurring.

Next visit in September (14-15)
San Diego County Co-occurring Cadre: Ken and Chris were honored to have dinner with a team of people representing the original Co-occurring Cadre (of trainers and change agents) that ZiaPartners developed in San Diego County in 2002-3. This Cadre has continued to train new cadre members and change agents, and this year is Going to be the 20th cadre training, representing hundreds of individuals over the years. All programs in San Diego are required to take steps to become co-occurring capable, and this understanding has informed merger of Mental Health, Alcohol and Other Drug Use Disorder services for adults and children, as well as the county’s approach to the new MediCal waiver Organized Delivery System, and to the integration of health and Behavioral Health, as well as addressing homelessness.
Ken and Chris were excited to meet with longstanding colleagues who still have enormous passion and energy for change: Piedad Garcia, County Adult Services Director (Mental Health & Alcohol and Other Drug Use Disorders), Virginia West (retired from the County) and Alicia Outcault, Diego Rogers, Susan Ritter, Roxy Walnum, Roz Corbett, Nicole Laping, Victor Acedo, and Hais Lindeman from the Cadre.Vermont Co-operative for Practice Improvement and Innovation (VCPI): Ken and Chris were in Vermont on July 31 to help launch a VCPI project funded by the Department of Mental Health and AIDS Drug Assistance Program to improve Co-occurring competency, through simultaneous access to selected modules of the Hazelden Focus on Integrated Treatment Curriculum, along with ZiaPartners facilitated learning community among 12 agency competency development teams across the state. ZiaPartners has also prepared a Co-Occurring Disorders orientation video that is available to VCPI members on the VCPI website (www.vtcpi.org) and a Supervision video (which accompanies the ILSA Supervision workbook). This event was attended by approximately 50 excited team participants and led to a lot of energy and discussion about how best to organize ongoing learning and supervision for all staff working with co-occurring disorder clients (which is pretty much all staff!).

Thanks to Karen Crowley and Amy Stonoha of VCPI for putting this together, and to Nick Nichols and Carolyn McBain of the Department of Mental Health, and Ryan Lane of AIDS Drug Assistance Program for their support of the project.
For non-VCPI members (that is, people not in Vermont), A more general version of the Co-ocurring Disorder orientation video is available for purchase on Vimeo.